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TEST3.3
| Question | Answer |
|---|---|
| The majority of blood supply to the liver, which is rich in nutrients from the gastrointestinal tract, comes from the: | portal vein |
| The liver plays a major role in glucose metabolism by: | participating in glucogenisis |
| The liver synthesizes prothrombin only if there is enough: | vitamin K |
| The substance necessary for the manufacture of bile salts by hepatocytes is: | cholesterol. |
| The main function of bile salts is: | fat emulsification in the intestines. |
| Hepatocellular dysfunction results in all of the following | decreased serum albumin, elevated serum bilirubin, increased blood ammonia levels. |
| Jaundice becomes evident when serum bilirubin levels exceed: | 2.5 mg/dL |
| The liver converts ammonia to urea. What level of ammonia would suggest liver failure? | 300 mg/dL |
| The most common cause of parenchymal cell damage and hepatocellular dysfunction is: | malnutrition |
| Negative sodium balance is important for a patient with ascites. An example of food permitted on a low-sodium diet is | one cup of powdered milk |
| The nurse expects that the diuretic of choice for a patient with ascites would be | Aldactone |
| An indicator of probable esophageal varices is | hematemesis, a positive guaiac test, melena |
| The mortality rate from the first bleeding episode for esophageal varices is about | 30% to 50% |
| Bleeding esophageal varices result in a decrease in: | renal perfusion |
| The initial model of therapy to treat variceal hemorrhage that decreases portal pressure and produces costriction is: | Pitressin. |
| A person who consumes contaminated shellfish would probably develop: | hepatitis E. |
| The hepatitis virus that is transmitted via the fecal-oral route is: | hepatitis A virus |
| Immune serum globulin provides passive immunity against type A hepatitis in those not vaccinated if it is administered within 2 weeks of exposure. Immunity is effective for about: | 2 months. |
| Choose the correct statement about hepatitis B vaccine | All persons at risk should receive active immunization |
| Indications for postexposure vaccination with hepatitis B immune globulin include: | accidental exposure to HbAg-positive blood, perinatal exposure, sexual contact with those who are positive for HbAg |
| The chemical most commonly implicated in toxic hepatitis is | chloroform, gold compounds, phosphorus |
| Fulminant hepatic failure may progress to hepatic encephalopathy about how many weeks after disease onset? | 8 weeks |
| Late symptoms of hepatic cirrhosis include all of the following except | edema, hypoalbuminemia, hypokalemia |
| Cirrhosis results in shunting of portal system blood into collateral blood vessels in the gastrointestinal tract. The most common site is: | the esophagus, the lower rectum, the stomach |
| Signs of advanced liver disease include: | ascites, jaundice, portal hypertension |
| The most common single cause of death in patients with cirrhosis is: | ruptured esophageal varices. |
| Hepatic lobectomy for cancer can be successful when the primary site is localized. Because of the regenerative capacity of the liver, a surgeon can remove up to what percentage of liver tissue? | 90% |
| What percentage of the liver needs to be damaged before liver function tests are abnormal? | 70% |
| The two major complications of a liver biopsy are:____ and____. | bleeding and bile peritinitis |
| The mortality rate for hepatitis B can be as high as what percent? | 10% |
| The most common reason for liver transplantation is exposure to _ | hepatitis c |
| Hepatocellular carcinoma is caused by:__, __, __, and __ | chronic liver disease, hepatitis b, hepititis c, and cirrhosis |
| The leading cause of death after liver transplantation is | infection |
| hypoprothrombinemia | Vit K |
| beriberi and polyneuritis | thiamine |
| hemorrhagic lessions of scurvey | vit. c |
| night blindness | vit. a |
| macrocytic anemia | folic acid |
| skin and neurologic changes | pyridoxine |
| mucous membrane lesions | riboflavin |
| Before a liver biopsy, the nurse should check to see that | a compatible donor blood is available, coagulation studies have been completed, vital signs have been assessed |
| The nurse knows that the biopsy needle will be inserted into the liver between the: | sixth and seventh ribs |
| The nurse is aware that postoperatively the most common complication after liver transplantation is: | bleeding. |
| The nurse knows that a patient receiving cyclosporine to prevent rejection of a transplanted liver may develop a drug side effect of: | nephrotoxicity. |
| Bile is stored in the: | gallbladder |
| A patient is diagnosed with gallstones in the bile ducts. The nurse knows to review the results of blood work for a: | serum bilirubin level greater than 1.0 mg/dL. |
| The major stimulus for increased bicarbonate secretion from the pancreas is | secretin |
| An action not associated with insulin is the | conversion of glycogen to glucose in the liver |
| The nurse knows that a patient with low blood sugar would have a blood glucose level of: | 55 to 75 mg/dL |
| A patient with calculi in the gallbladder is said to have: | cholelithiasis |
| The obstruction of bile flow due to cholelithiasis can interfere with the absorption of | vitimin a |
| Clinical manifestations of common bile duct obstruction include all of the following | clay-colored feces, pruritus, jaundice. |
| The diagnostic procedure of choice for cholelithiasis is | ultrasonography |
| Pharmacologic therapy is frequently used to dissolve small gallstones. It takes about how many months of medication with UDCA or CDCA for stones to dissolve? | 6 to 12 months |
| Chronic pancreatitis, commonly described as autodigestion of the pancreas, is often not detected until what percentage of the exocrine and endocrine tissue is destroyed? | 80% to 90% |
| Mild acute pancreatitis is characterized by | edema and inflammation |
| A major symptom of pancreatitis that brings the patient to medical care is: | severe abdominal pain |
| The nurse should assess for an important early indicator of acute pancreatitis, which is a prolonged and elevated level of: | serum lipase |
| Nursing measures for pain relief for acute pancreatitis include | encouraging bed rest to decrease the metabolic rate, teaching the patient about the correlation between alcohol intake and pain, withholding oral feedings to limit the release of secretin |
| The risk for pancreatic cancer is directly proportional to | smoking |
| With pancreatic carcinoma, insulin deficiency is suspected when the patient evidences | an abnormal glucose tolerance, glucosuria, hyperglycemia |
| Clinical manifestations associated with a tumor of the head of the pancreas include: | clay-colored stools, dark urine, jaundice. |
| A nurse should monitor blood glucose levels for a patient who is diagnosed as having hyperinsulinism. A value inadequate to sustain normal brain function is: | 30 mg/dL. |
| Zollinger-Ellison tumors are associated with hypersecretion of | gastric acid. |
| The capacity of the gallbladder for bile storage is:_____ mL. | 30-50 mL |
| Digestive enzymes are secreted by the pancreas;______ aids in the digestion of carbohydrates,_______aids protein digestion, and_____ aids the digestion of fats. | amylase, trypsin, and lypase |
| The endocrine secretions of the pancreas are:____ ,_______ , and___ . | insulin, glucagon, and somatostatin |
| The primary cause of acute cholecystitis is | calculous cholesistitis |
| The most serious complication after a laparoscopic cholecystectomy is | bile duct injury |
| A major cause of morbidity and mortality in patients with acute pancreatitis is | pancreatic necrosis |
| asaterixes | involuntery flapping movement of the hands associated with metabolic liver dysfunction |
| Budd-Chiarri Syndrome | hepatic vein thrombosis resulting in non-cirrhotic portal hypertension |
| constructional apraxia | inability to draw figures in two or three dimensions |
| fetor hepaticus | sweet, slightly fecal odor to the breath. presumed to be of intestinal origin, prevalent with the extensive collateral portal circulation in chronic liver disease |
| fulminant hepatic failure | sudden severe onset of acute liver failure that occurs within 8 weeks after the first symptoms of jaundice |
| hepatic encephalopathy | cns dysfunction resulting from liver disease associated with high ammonia levels that produce changes in mental status, altered loc and coma |
| orthotopic liver transplantation (OLT) | grafting of a donor liver into the normal anatomic location with the removal of the diseased native liver |
| portal hyertension | elevated pressure in the portal circulationresulting from obstruction of venous flow into and through the liver |
| sclerotherapy | injection of substance to esophageal varices to cause constrioction, thickening, and hardening of the vesel to stop bleeding |
| variceal bleeding | involves endoscopic placement of a rubber band like device over esophageal varices to ligate the area and stop bleeding. |
| xenograft | transplantation from one species to another |
| dissolution therapy | use of meds to break up or disolve gallstones |
| endocrine | secreteing internally; hormonal secretion of a ductless gland |
| endoscopic retrograde cholangiopancreatography (ERCP) | endoscopic procedure using fiberoptic technology to visualize the biliary system |
| exocrine | secreting externally; hormonal secretion from excretory ducts |
| lipase | pancreatic enzyme; helps with the digestion of fats |
| panceaticojejunostomy | joing of the pancreatic duct to the jejunum by side to side anastomosis; allows drainage of the pancreatic secretion into the jejunum |
| secretin | responsible for stimulating secretion of pancreatic juice; also used to aid in diagnosing pancreatic exocrine disease and in obtaining desquamated pancreatic cells for cytologic exam |
| steatorrhea | frothy foul smelling stools with high fat content; results from inpaired digestion of proteins & fats due to lack of pancreatic juice in the intestines |
| trypsin | pancreatic enzyme that aids in digestion of proteins |
| Zollinger-Ellison tumor | hypersecretion of gastric acidthat produces peptic ulcersas a result of a non-beta cellor tumor of the pancreatic islets |
| Glycogenesis | formation of glycogen from glucose |
| Glycogenolysis | conversion of glycogen into glucose for energy |
| Gluconeogenesis | formation of glycogen from amino-acids Occurs in the liver when there are excess amino-acids & decreased carbohydrate-intake |
| for the process of Gluconeogenesis | the liver uses amino-acids from protein-breakdown or lactate produced by exercising muscles (from fats and proteins). |
| Ammonia, a potential-toxin, | metabolically-generated as a by-product of gluconeogenesis (results from protein-breakdown). |
| Ammonia is converted-into-urea | This is how liver rids the blood of toxic-ammonia. Urea is excreted in urine |
| Hormone-Metabolism | > Aldosterone - sodium (Na) and water (hhO) retention o Is secreted by adrenal-cortex > Estrogen - secondary sexual-characteristics in women > Testosterone - secondary sexual-characteristics in men |
| ADH — antidiuretic-hormone, decreases urine-secretion | o secreted by hypothalamus o naturally occurring ADH is vasopressin o pharmaceutically-prepared ADH is Pitressin |
| Albumin decreases with | ascites and cirrhosis |
| Vit. K = necessary for | prothrombin-synthesis & some of the other clotting-factors. |
Created by:
sandjlambert1